The Choice

CommentsParents across the country are increasingly weighing the health risks of letting their children play football against the joy the sport can bring. (Getty Images)

MARIETTA, Ga. -- His name is Parker. Everyone called him Tank. In his first season of youth football, he made two boys cry. Knocked three boys out. He was 4 years old, going on 5, big and strong for his age. A bobble-headed bulldozer. His mother didn't mind. She was too busy cheering. Boy, get out there and hit somebody!

Besides, Monet Bartell was the one who signed her son up.

"My husband wanted him to play chess," she says.

Her husband, Melvin Bartell, concurs. The three of us are having dinner. It's August. Another season is about to begin, and I'm here to answer a question: Should your child play football? The answer, of course, is complicated, because the question is complicated. It's hard to know where to begin. What to believe. Who to trust. How to weigh the risks against the rewards. I'm hoping Monet can help. Only now she's asking me for help.

"Do I want my son to play football?" she says.

A long pause. Melvin is silent. Monet lets the question hang. Her father, Mel Farr Sr., played in the NFL for seven seasons. Her uncle also played in the league, as did both of her brothers and a number of cousins. Before Parker was even born, Monet had his life mapped out: Play football at UCLA, and then play in the NFL. Just like her dad. Just like her brothers, Mel Jr. and Mike. Such was the plan. It did not include chess. And then one day in 2011 -- around the same time Parker first put on a helmet and shoulder pads -- a relative wanted to talk. About the problems in his life. The problems in his head. Dark, desperate thoughts. He was done with football -- had been for years -- but scared that football wasn't done with him.

"Have you heard of CTE?" he said. "I believe that is what I am suffering from."

Monet had heard a little. Not a lot. She knew it was a disease, a bad one, and that it happened to other people. She started going online, searching for answers, for help. She read about concussions. Suicides. Lawsuits. Brain bleeds. Blows to the head. Former football players suffering from depression and memory lapses, cognitive and emotional dysfunction, weird neurological diseases with hard-to pronounce names, like chronic traumatic encephalopathy and amyotrophic lateral sclerosis. She learned that helmets protect the skull, not the brain, and that even boys as young as Parker could suffer lasting damage. She found herself sitting in the stands at the youth league championship game, chatting with another team mother. Both had a choice to make, and the choice was harder than ever before.

Would their sons continue to play football?

Earlier that season, Parker had leveled another boy. He earned a personal foul. Monet remembered the moment, how proud she felt as her son skipped back to the sideline.

Mommy! Mommy! I made a kid eat dirt!

"I sat back and said, 'Wow,'" she says. "What if I'm the parent of that other kid?"

* * *

Football is fun. And football means eating dirt. That's the tradeoff. Always has been. The game is inherently dangerous, rooted in violence and physical domination, hitting and tackling, knocking your opponent on their ass before they do the same to you. Football breaks bones, shreds ligaments, ruptures internal organs. Occasionally, it kills.

And yet for just about forever, the harm has seemed manageable. Perfectly acceptable. A reasonable price to pay for both Friday Night Lights and weekend tailgating. Because bones heal, and ligaments can be fixed. Deaths are horrific, but freaky and rare. Week after week, season after season, the sport teaches life lessons, rallies communities, provides excitement and entertainment for millions, inspires military flyovers and breast cancer awareness drives. It helps define American masculinity and pays NFL commissioner Roger Goodell's $29.5 million salary. At the youth level, most players walk away from the game with fond memories and without serious, lasting harm; for parents and society alike, football's rewards largely have outweighed its risks, so much so that even in an era of helicopter parenting and school safety zones, more than four million American children play high school and youth football.

Because of brain damage, that calculus is changing.

* * *

Scott Hallenbeck is sweating. Profusely. Like a human lawn sprinkler. I can't blame him. It's an early November morning in Washington, D.C., and the Aspen Institute's Sport and Society program is hosting a roundtable discussion on youth football safety and the sport's future. The NFL's top lobbyist is here. So is the head of the players' union. There are journalists and academics, lawyers and school officials, coaches and scientists.

Almost everyone is a parent.

Sports concussion expert Robert Cantu proposes that children under age 14 not play tackle football, largely because both their brains and bodies are still developing and therefore more vulnerable to serious injury. This puts Hallenbeck in a tight spot. He's the executive director of USA Football, the NFL's national youth arm. His day job involves telling America why its children should play tackle football, the same way his 16-year-old son does.

"I think we all recognize there are challenges," Hallenbeck says. "We're all looking for ways to try to create a better and safer environment for parents and players. I also hope that we're in this to provide accurate and whenever possible evidence-based data for parents. I think we have to be careful certainly not to scare parents."

Now consider the human brain. It's essentially a blob of Jell-O, floating inside the skull like an egg yolk. Getting hit in the head -- or just experiencing a sudden change in momentum, like the kind that comes from a blindside tackle -- can cause the brain to stretch, warp and collide with the bony inner surface of the skull. This produces damage. The damage can be structural, akin to a cracked microchip in a laptop computer. It can be metabolic, like the same computer suddenly losing its electrical supply. Some damage is obvious, visible from the sidelines. Other damage is subtle, almost impossible to detect, even for trained experts in a clinical setting.

The effects of football collisions on young brains are still being studied. (Getty Images)With adequate rest and recovery, most concussions resolve themselves in a relatively short period of time. But other damage -- such as neurodegenerative diseases and severe cases of post-concussion syndrome -- never does. Current research indicates that damage can be cumulative; that getting hit in the head repeatedly is worse than getting hit once or twice; that both concussive and sub-concussive blows are dangerous; and that getting hit while recovering from a previous blow or concussion is particularly risky. There currently is no definitive causal link between youth football and long-term neurodegenerative disease. Yet depending on duration and severity, brain damage can mean missed games. Missed classes. Learning disabilities. Changes in mood, memory, personality. It can permanently alter who you are, and who you have a chance of becoming.

"No brain trauma is good brain trauma," Cantu says. "We're not paranoid about it, but when you can reduce it -- or every chance you get to eliminate it short of stopping something completely -- it's a good thing."

Should your child play football? Start with a simple fact: No helmet can prevent any of the above.

* * *

As a child, Monet didn't worry about what football helmets can't prevent. She enjoyed what the sport could provide. The game took her father, Mel Sr., from a home without indoor plumbing in segregated Beaumont, Texas, to his first drink of cold water from a refrigerated fountain on the UCLA campus. He parlayed his standout career with the Lions -- two Pro Bowl selections and the 1967 Rookie of the Year award -- into an offseason job with Ford, later building a network of car dealerships that eventually became one of the largest black-owned businesses in the U.S.

"When I went to college, I shrunk my first comforter," Monet says. "Because I didn't know how to do laundry. I had never bothered to learn. That's when I realized I grew up rich."

Monet grew up with money, and she grew up with football. Lions running back Billy Sims was a frequent guest at her family's suburban Detroit home. Hall of Famer Barry Sanders showed up to watch one of her high school plays. Dad had a box at the Pontiac Silverdome. Monet was there with him for every Lions home game. When her brothers played at UCLA, Monet would get out of school on Friday afternoons, hop on her father's plane and fly to wherever the Bruins were playing. When her brother Mel Jr. played for the Los Angeles Rams, she went to the American Bowl in Germany, right after the fall of the Berlin Wall. "I had pieces of it," she says. "I can't find them. That's how carefree we were. It's all a blur. We were always at a game. Every single weekend."

In high school, Monet played tennis. It was a choice made out of chromosomal necessity. Her uncle, Miller, played 10 seasons in the NFL and the American Football League. Cousins Jerry Ball and D'Marco Farr also played in the NFL. When Mel Sr. met Monet's mother, Mae, he told her that he wanted 11 sons. An entire football team. Some of Monet's earliest memories are of her father coaching her brothers in Pee Wee football. Dad was a drill sergeant. Every morning, he ran the boys through backyard agility exercises. He would sit in a sled and have his sons drag it up a large hill. On the sidelines, he wore a leather visor and pork chop sideburns. He smoked Kool Milds. The Birmingham-Bloomfield Vikings went undefeated. Didn't give up a single point. Monet was a cheerleader -- and again, it wasn't her first choice.

"I would have played [football] if I could have, absolutely," she says. "Even today, I've never sat and watched my nephew play. My brother Mike coaches him, and I'm on the sideline, yelling at him."

"I stand on the sideline, too," says Monet's mother, Mae.

"The other moms drink wine from coffee cups," Monet says. "I don't dress up cute. I'm there for the game."

When Parker turned four, Monet searched for a local youth football league that would take children that young. She wanted him to play. Get his first taste of the family business. No question in her mind. When she found one, she was pumped. God bless the South. "Our coach's son was three years old when he first came out," she says. The boys went through spring training -- no, really -- doing bear crawls and running through tires. They had full contact practices, complete with Oklahoma drills, coaches screaming knock his lights out! The actual games were full-fledged events, with packed stands and tailgating adults.

For Monet, all of it felt familiar. Like an old childhood blanket. Was she worried about brain trauma?

"No," she says. "I was getting mad at [Parker] if he didn't tackle, like, 'What are you doing out there?'"

* * *

USA Football's "Heads Up Football" attempts to teach proper form in tackling to prevent injury, but not everyone is convinced. (USA Today SPORTS).

University of North Carolina researcher Kevin Guskiewicz studies football collisions for a living. Big hits and little ones. Full-speed human missile strikes. Mundane helmet-to-helmet blows delivered across the line of scrimmage after every snap of the ball. Much of his analysis involves using sensor-equipped helmets to measure impact forces and locations. Guskiewicz has been doing this since the 1990s, and his campus office is home to one of the world's most extensive databases of football brain-rattling.

He also has three sons. One of them, a high school junior, plays football. The other two have given up the sport in favor of baseball and basketball.

"I never pushed or pulled them to play," he says. "As long as I knew there was a coach out there who cared about health and safety, it was fine."

Guskiewicz published some of the earliest research linking football to long-term cognitive harm. At one point in time, he was an outspoken critic of the NFL's decades-long campaign to deny and minimize that connection. While working as an athletic trainer for the Pittsburgh Steelers, he saw the sport's brutality up close.

That said, he coached his sons in youth football, and says he would do so again.

"For some reason everybody thinks there is a concussion epidemic," he says. "That frustrates me. I sustained two concussions playing football in high school myself. There's not an epidemic. We just know a lot more about them and care more about them than we ever have. We need to be smart about how we're doing this."

Should your child play football? In most cases, Guskiewicz isn't against it. But he can't really answer for anyone else. Not his place. There are too many variables to consider. Besides, his work focuses on a different question: What, if anything, can be done to make football safer?

The NFL, some college conferences and a number of high school and youth leagues have mandated limits on full-contact practice, the better to reduce the total number of head hits that players absorb. Guskiewicz believes that's a good first step. So do many others. He also advocates for state laws requiring that players who show signs of being concussed be removed from games or practices and not be allowed to return until they're cleared by a health care professional -- largely because research indicates that unresolved concussions leave the brain more vulnerable to additional damage and concussions, which in turn increase the risk of long-term harm. The worst-case scenario? A condition called second-impact syndrome, in which an athlete suffers a second concussion while still recovering from a previous one. Though the precise physiological cause is uncertain, the outcome is not: the brain swells rapidly and catastrophically, causing severe disability or death.

Of course, there's a problem with said laws, a problem that dogs football at every level. How do you spot concussions in the first place? Self-reporting is unreliable. Players are conditioned to hide injuries. The sport's entire ethos revolves around playing through pain. Moreover, brain damage affects the seat of awareness, so even a player who wants to report a concussion may not realize that he has one. As for coaches? They're distracted. Mostly unqualified. Asking them to consistently diagnose a mysterious, invisible injury is foolhardy. Would you ask a neurologist to draw up a goal line defensive play?

Speaking of neurologists: The NFL recently required teams to have an independent one on the sideline at every game. During Philadelphia Eagles home games, said neurologist is joined by an orthopedic surgeon, an internal medicine specialist, a spine specialist, a chiropractor, a dentist, a podiatrist, an ophthalmologist and an anesthesiologist.

"If I said that one in 10 middle schools has an athletic trainer, I'd probably be overestimating," Guskiewicz says. "Having a trainer isn't going to prevent every injury or solve every problem. But it's important. Some people say this is extreme, but I think that at the high school level, if you can't afford to hire a certified athletic trainer, then you shouldn't field contact sports at your school."

No trainer? No contact sports for kids. A simple formula. But doesn't it imply that the vast majority of youth football programs -- short of trainers but stocked with vulnerable young brains -- ought to be shut down?

Guskiewicz winces.

"It's a problem," he says.

Cantu has written an entire book arguing that children under 14 shouldn't play contact sports. NFL Hall of Famer Ron Mix thinks the prohibition on youth football should extend to age 15. Hockey Canada recently outlawed body-checking for 11- and 12-year-old players, citing a study that showed that youth players in checking leagues were four times more likely to suffer concussions than players in leagues without contact. Numerous NFL players -- including New England Patriots quarterback Tom Brady -- didn't start playing tackle football until high school, and New Orleans Saints quarterback Drew Brees says he won't consider allowing his three sons to play tackle until they're teenagers. Should children be playing flag football exclusively?

Guskiewicz says no.

"I'm adamantly opposed to the suggestion of banning contact sports for kids under some age," he says. "One, we don't even know what that age should be. Two, if the first time a kid is going to strap on a helmet or shoulder pads and play football or hockey is at age 15 or 16 when the weight differential between players [colliding] could potentially be 80-90 pounds -- like a 210-pound senior linebacker tackling a 130-pound freshman -- that is when you're going to have problems, if it's the first time you're trying to protect yourself. I'm a proponent of teaching kids how to tackle and block properly at younger ages."

Guskiewicz brings up a football video on his desktop computer. A North Carolina player lowers his head while making a block. Thwack! The collision delivers 104 Gs of force to the side of his helmet. He sustains a concussion. Up comes a second video, this from a game that took place a month later. The same player makes another block -- only this time, he strikes his opponent with his left shoulder, remaining mostly upright and turning his body to shield his head.

"See that?" Guskiewicz says. "It's an entirely different approach. We taught him to do that. We can change behavior. And that's in a college player. It's a hell of a lot easier to do with a high school team."

This, according to Guskiewicz, is the future. Behavior modification.Teaching players to tackle without hitting their heads, assuming that's possible. Guskiewicz is a member of the NFL's Head, Neck and Spine Committee. In conjunction with USA Football, the league is aggressively pushing the safe tackling concept on youth coaches and nervous parents through a program called "Heads Up." Goodell himself insists that it works, that it makes the sport "safer than it has ever been" and moves closer to "taking the head out of the game" entirely.

I have doubts.

In USA Football's glossy tutorial videos, boys practice their new-and-improved tackles against empty air, foam pads and stationary opponents who seem to be imitating scarecrows. Tackling is broken down into five distinct stages. There's plenty of time and space to take just the right angle, launch into a tackle, maintain perfect form, keep one's head from getting bashed by tucking it under an opponent's armpit. Football becomes an exercise in aggressive, studied chest-bumping. It really does look safer.

Thing is, the actual sport is completely different. Uncontrolled chaos. Players of varying sizes and strength run at full speed. They trip and shove and hit and fall, pin-balling around at ever-changing heights and angles. When I showed a Heads Up tackling video to a pair of college football players, both shook their heads. When I asked former NFL player Nate Jackson about it, he laughed. Knocking someone else to the ground, he explained, means getting leverage on them. Which means getting low. Which means dropping your shoulders. Drop your shoulders, and your head will follow.

I also asked longtime Chicago Sun-Times sports columnist and former All-Big Ten defensive back Rick Telander about Heads Up. His reply was dryly incredulous: Does the ball carrier cooperate with you?

"Have I seen behavior modification not work?" Guskiewicz says. "Absolutely. It doesn't work 100 percent of the time. But I've seen it work."

In fairness to Guskiewicz, his program is far more involved than the NFL's youth tackling clinics. This season, players at nearby Chapel Hill High School have been outfitted with special helmets that measure the location and intensity of hits to the head. When a player suffers a series of what Guskiewicz calls "bad hits" -- that is, head hits that are too hard, too frequent or too often on the crown of the helmet, based on deviations from previously established positional averages -- trainers and coaches will study video with the player and attempt to make changes to their collision technique.

"During the first half of the season, we identify who has a bad hit profile," he says. "We put them into a coaching intervention that links video footage and data from accelerometers in their helmet. Then we study them for second half of the season to see if we can reduce those bad hit numbers and put them into safer play."

One problem: The force threshold for "bad hits" is largely a matter of guesswork -- while some studies suggest that hits over 60 to 80 Gs significantly increase the likelihood of concussion, there is no hard and fast rule. One player can absorb a 100G blow and appear perfectly fine; another can take a 30G hit and be knocked out cold. No hits are good hits. Moreover, basing the "bad hits" frequency threshold on positional averages seems odd. A defensive back who absorbs 250 hits to the head during the first half of a season might be in line for an intervention; a defensive lineman who absorbs the same total might not. Are their brains all that different?

More doubts. I express them to Guskiewicz. I tell him that both the Heads Up push and new rules across football penalizing certain types of helmet hits seem like a replay of the 1970s, when football responded to criticism from the American Medical Association by banning "butt-blocking" (blows delivered with the face mask or front and top of the helmet to an opponent in close line play) and "face tackling" (driving the face mask or front and top of the helmet into a runner), all while calling on coaches to teach "correct, head-up blocking and tackling."

Has anything really changed?

"We have a kid at the high school who I already know -- based on watching video from last year on kickoffs -- has a bad hits profile," Guskiewicz says. "We're already starting to work with him for this season. I can show you video footage of a guy who changed his behavior in three weeks. We've been working on this for eight years. We didn't come up with it overnight."

Suppose Guskiewicz is right. Suppose he's onto something. Sensor-equipped helmets are expensive. Video intervention takes time. Guskiewicz's lab is partially funded by the NFL, and staffed by paid research assistants. What about the typical Pop Warner squad? Or high schools that already are facing budget shortfalls? I'm reminded of something journalist Stefan Fatsis said at the Aspen Institute roundtable:

You're talking about putting accelerometers in equipment. Equipment specialists to outfit our children. Having independent observers of coaches on the sidelines at practices and games to monitor what's going on. At what point are we kidding ourselves about youth football, that this is not a sensible proposition when you need this superstructure for every game in the country?

I'm also reminded of something else Guskiewicz told me, the first thing out of his mouth when I asked him if children should play the sport.

"It's not for everyone," he said.

* * *

Monet shakes her head. She knows it sounds ridiculous. Looking back, she really should have known better. After all, she once watched her brother Mike get knocked unconscious during a Lions game. Her mom ran down to the team's bench. Monet stayed put and bawled. Sitting in the very same Pontiac Silverdome skybox, she also saw Detroit lineman Mike Utley taken off the field on a stretcher after suffering a 1991 spinal injury that left him paralyzed from the waist down.

Monet felt a chill, a queasy sensation in her stomach. But never mind that.

"I honestly didn't realize that football was violent," she says. "It was just football. Even now, with my [family member] suffering, when I watch a game and they're trying to make calls about players hitting too hard, fining them, I don't know if they should do that. It's like, 'That's football!'"

On the same afternoon that Utley lost the use of his limbs, Mike Farr caught his first and only NFL touchdown pass. That's football. Three years later, as paramedics treated Monet following a car accident, Mike saw his bloodied sister in a stretcher and cried. He immediately thought of Utley. That's football.

Two summers ago, Monet was watching the Pro Football Hall of Fame induction ceremony with a relative. The one who suspects he has CTE. He recalled constant headaches, keeping Advil in his football pants, popping pills on the field; he remembered washing down caffeine pills with cola in the locker room after games, the better to not fall into a woozy sleep. He hardly knew what concussions were, let alone what they could do. He didn't care. He just wanted to play the game.

That's football, too.

"I always say it's like a drug or alcohol addiction," Monet says. "Leaving the sport is like trying to quit cold turkey. It's very difficult to lose it."

Monet saw her relative's life crumble. Weight loss. Erratic behavior. Bad decisions. Family problems. A short stint in a mental health facility. In public, he was charismatic and charming; in private, brooding and lethargic. He all but lived in a basement. No one in the family knew what was wrong. No one knew what to do about it. "At first it was just like, 'What happened to you?'" Monet says. "'Snap out of it. It's not that big of a deal!' But now we see that he can't snap out of it."

The family closed ranks. Wouldn't let Monet's relative be alone. They started reading. Talking. Reaching out. Monet contacted former NFL running back Dorsey Levens, who was producing a documentary film on football and brain damage. Mel Sr. found himself attending more and more funerals for men he played football with. Strong, proud men, like Hall of Famer John Mackey. Mackey was the first head of the players' union. Monet's father looked up to him. Calls him "a god." He died at 69, after struggling with dementia. Mel Sr. started emailing articles to his daughter, stories about former players suffering from mental problems. Wow. Did you read about this guy?

Monet came across a story about the first concussion lawsuits filed against the NFL. She learned that former league commissioner Paul Tagliabue created a committee in the mid-1990s to study football-induced brain damage. That the committee put out a series of since-discredited scientific papers asserting that concussions posed neither short- nor long-term health risks, defying both independent research and common sense. That league doctors used those papers to justify and continue the longtime practice of clearing concussed players to return to action in the same games they were injured in, increasing the odds of lasting damage. That league scientists suggested in print that the same practice might be fine for college and high school players. She learned that the NFL had waged a scientific and public relations war to downplay and dismiss the link between football and brain damage, and that Goodell had presided over a pattern of ongoing denial -- one that extended all the way down to youth football, and by extension, her son Parker.

This was football? Monet was furious.

"I had no idea about the first NFL committee," she says. "I had chill bumps when I read that. My eyes turned red. Nobody wants to admit the fact that their organization is costing lives and people having decent lives. Who wants to go to bed saying, 'That was my fault?' It's so much easier to say it's not."

Last year, former NFL linebacker Junior Seau committed suicide by shooting himself in the chest. At the league's direction, scientists from the National Institutes of Health subsequently examined his brain. They diagnosed him with CTE. Publicly, NIH doctors declined to speculate on the cause of Seau's disease; privately, they reportedly told Seau's family that football was responsible.

Monet's brother, Mel Jr., played football with Seau. Monet attended the grand opening of Seau's San Diego restaurant. Both were watching television news coverage on the day of Seau's death, along with Mike and their mother. During a live press conference outside Seau's home, his mother, Luisa, stood at a podium. She broke down in grief.

Take me! she sobbed. Take me!

"My whole family was in tears, watching her crying," Monet says. "As a parent, as a mom, that was the hardest thing to watch."

* * *

Imagine this: a pharmaceutical company invents a new drug. A drug with many benefits. It increases cardiovascular fitness, facilitates friendship, creates feelings of excitement, euphoria and community pride. As a side effect, however, the drug also produces varying degrees of acute and chronic brain damage in an indeterminate number of users, for reasons that are only crudely understood.

The drug, of course, is football. Which is why Lewis Margolis can't help but ask: Should anyone's child play the sport?

"I'm not saying that everyone should be placed into bubbles," he says. "But we have enough evidence now to know that there are harmful consequences from these traumatic brain injuries. We know that. And kids are exposed to this. To continue to allow children to participate [in football] in an unencumbered way, to me, is no different than exposing them to an untested medicine or medical device. Only it's being done without the tools, procedures and protections essential to medical research."

A public health professor at the University of North Carolina, Margolis specializes in maternal and child health. His campus office is a 10-minute walk from Guskiewicz's. His views on youth football might as well be from another planet. In an opinion article published on the website Inside Higher Ed, Margolis argued that allowing children to play tackle football is not only the equivalent of an uncontrolled, nationwide research project in concussion medicine and science, but also an unethical project that parallels the infamous Tuskegee Study -- in which the U.S. Public Health Service monitored but did not treat a group of rural African-Americans suffering from syphilis over a period of decades.

"That article raised the eyebrows of people around here," Guskiewicz says. "The analogy is absurd and embarrassing."

Guskiewicz has a point: Likening football to venereal disease is pretty out there, even as a thought exercise. Margolis admits as much. He also notes that parents, coaches, school administrators and concussion researchers all have the best interests of children at heart -- unlike the Tuskegee scientists, who didn't even tell their research subjects what was happening.

Still, Margolis maintains that the football-to-research comparison is apt. And he's not alone. According to the book "League of Denial: The NFL, Concussions and the Battle for the Truth," the NFL once contracted with a bioengineering firm to help run a first-of-its-kind epidemiological study of concussions in professional football. A memo from the firm read as follows:

A major obstacle to head injury research is the unavailability of willing test subjects. The NFL has graciously sponsored a research program offering its players as those living subjects.

"Just because you're doing something with goodwill doesn't make it ethical," Margolis says. "If Kevin [Guskiewicz's] research or my research generates a risk, then we have to ask, 'Is that risk acceptable?' Is an 80 percent increased risk of brain damage acceptable? Fifty percent? Ten percent? If football generates a risk, then we have to ask the same question. This is a discussion for public health. Not just coaches."

Public health focuses on preventing predictable problems. On stopping harm before it happens. Last year, the Consumer Product Safety Commission banned the sale of Buckyballs, small magnetic toys that can pinch intestines and require surgery when swallowed by children. Federal regulators enacted the ban following 22 swallowing cases over a three-year span. By contrast, youth football has produced far more than 22 concussions among children over the last three years. Seven high school football players have died this year, five from brain injuries and two from spine and neck injuries.

Yet society's response -- from the NFL to Pop Warner -- has been akin to a running yellow traffic light. Look into the problem, be more aware, spend some money on research, change a few rules. But keep driving. Margolis thinks it should be more like stopping on red: Figure out the risks of football in a controlled setting under established clinical standards, and then decide if children should participate.

This goes double for schools.

Schools, Margolis says, have two primary duties. Nurture young minds. And protect the children in their care. Hence, homework. Study halls. Anti-bullying campaigns. Not allowing drugs or guns on campus. Schools receive public funds -- and are tax-exempt institutions -- to help carry out these duties. No high school would start and sponsor an official mixed martial arts team. Not without provoking parent outrage.

What makes football -- a known vector of student brain damage -- so different?

"I'm not saying sports don't belong on campuses," he says. "But take UNC. How do they tolerate that they are knowingly sending kids out there [to play football] with some risk -- and we can disagree on the level -- when it's not consistent with the mission of the institution?"

In medical research, children cannot legally agree to participate in studies. Their parents or guardians have to give permission -- and even then, the consent has to be informed. Participants have to know what they're getting into. How much do most families know about brain damage and football? How much can they know, given both scientific uncertainty about the sport's risks and the football industry's concerted, ongoing effort to downplay those risks, particularly to children?

Last year, Goodell gave a speech on football safety at Harvard University's School of Public Health. He cited a recent study by the National Institute for Occupational Safety and Health (NIOSH), debunking the notion that NFL players had shorter life spans than the general population. He did not mention a second NIOSH study suggesting that pro football players were four times more likely to develop Alzheimer's or Lou Gehrig's disease. During an appearance on "Face the Nation" last February, he was asked to acknowledge the link between football and brain damage -- and promptly ducked the question, stating that "We're going to let the medical individuals make those points."

About those medical individuals: Sports concussion expert Cantu is an advisor to the league's health and safety committee. He recommends no tackle football for children under age 14. He was not present at a recent NFL-sponsored "Football Safety for Moms" clinic in Chicago. Instead, the league rolled out Chicago Bears neuropsychological consultant Elizabeth Pieroth, who, according to the Associated Press, "presented checklists for recognizing concussion symptoms and recommendations for treatment, but suggested on balance that 'boys like to hit things' and without proper channels for their aggression, they might do other things like drive too fast or drink too much."

None of this should be surprising. In the mid-1990s, then-NFL commissioner Tagliabue worried that football was losing cultural cachet. That the game wasn't cool. The league hired top executives from MTV, who reportedly drew up a marketing plan entitled "Game Plan 1997." The document addressed Tagliabue's concerns: Nothing can be more important than how we manage young people (particularly ages 6-11 ...) into our fan continuum and begin to migrate them toward becoming avid/committed fans ... critical action: Generate early interest and enthusiasm. Transform/convert their casual interest into commitment. Amplify to avidity. As one of the former MTV executives explained to New Yorker writer John Seabrook, "It's all about getting a football, this unusual-looking object, into a kid's hands as soon as you can. Six years old, if possible. You want to get a football in their hands before someone puts a basketball in their hands, or a hockey stick or a tennis racquet or a golf club."

Four years later, Goodell was invited to a Congressional hearing on brain trauma. He was scheduled to appear with the father of a Texas high school quarterback who had died after suffering a concussion. According to "League of Denial," NFL lobbyist Jeff Miller was apoplectic. He demanded that Goodell be placed on a different panel. Congressional staffers acquiesced.

"It's in the interest of the National Football League to cultivate doubt around this," Margolis says. "To say, 'We're interested in the well-being of kids, college players and our players -- but we need to be certain. Let's be certain about this brain trauma stuff. Don't want to jump to conclusions.' It's all about creating a sense of doubt and not being willing to address the problem."

Should your child play football? The choice, Margolis says, isn't just for parents. It's for all of us. Society needs to seriously weigh the risks and rewards, the games won and the damage done, the same as it has with lead paint and cigarettes.

He shows me an article. It's from TheWall Street Journal. The title? "In Defense of Football." Written by a military historian, it acknowledges that brain damage is a problem, but lauds the sport as a civic religion and argues that society should not "overreact to a handful of tragic injuries and legislate or litigate away a game that means so much to so many Americans." The author concludes by citing Teddy Roosevelt, who warned that abolishing the game would be "simple nonsense, a mere confession of weakness" and result in society producing "mollycoddles instead of vigorous men."

"It's the old thing about the Battle of Waterloo being won on the playing fields of Eton," Margolis says. "I don't disagree with that. My son played sports. My daughter played sports. Sports can produce laudable outcomes."

But?

"But whether you need to have people scrambling their brains in the process is doubtful," he says.

* * *

Monet's mother is showing me pictures. Photo albums. Framed shots. A family's football life. Mel Jr. in his UCLA uniform, featured in an advertisement on the side of a Los Angeles city bus. Mae and Mel Sr. with singer Smokey Robinson. Mike and Mel Jr. with their beaming father, all three wearing Lions uniforms. A collage of Mel Jr. and Mike's undefeated youth squad. Mike's 12-year-old son, Mikey, in his youth league uniform. Mae on a football field, holding a camera.

"I didn't want my boys to play football at first," Mae says. "But look at me. I would run up the sidelines when they would score a touchdown."

"It's almost like a bipolar love of the sport," Monet says.

"It gets your adrenaline going," Mae says.

"Then you go home and think about it," Monet says. "My gosh, it's a rough sport. I think about my family. When it hits home it's completely different."

"I used to sit in the [team] medical room with my mother-in-law when Mel [Sr.] would play," Mae says. "I never understood why she was so concerned. Not until my boys started to play did I understand what that was like for her."

"But even though I have that feeling, I'm still right down there on the field," Monet says. "If it's fourth-and-goal at my nephew's games, I can't watch."

"My mother watches football and she is 95," Mae says. "I'm missing Mikey's scrimmage right now. Football gave our lives such dimension."

Remember that Marist College survey? The one in which a third of Americans said concussion concerns would make them less likely to allow their children to play football? Seventy percent of the respondents thought the benefits of the sport outweighed the risks. The choice is hard. Football is a new car and a full tank of gas. Brain damage is climate change.

It's a Saturday morning. Monet is making breakfast. Mike couldn't join us. He's coaching his son's scrimmage. I ask Monet's 14-year-old daughter, Paige, if football is a big deal at her high school. She nods. Her eyes go wide.

"When they have games, you can't find a place to park," Monet says.

"People who live across the street from school charge to park," Paige says.

Young Parker Bartell isn't playing football this year, though even if his parents let him, he doesn't really want to."There are thousands of people there," Monet says. "Everything at the school is scheduled around football season. My daughter is in a play. The dates of the play coincide with the playoffs. If the team makes the playoffs, they've already planned on moving the play."

Parker wants to show us something. His football trophy. It's nearly as tall as he is. He received it at the end of his first season, and it was pretty much his favorite thing about the sport. Well, that and the team banquet. Turns out Tank didn't really like football -- he would knock opposing boys down, sure, but only so he could more quickly get back to the sideline and continue playing his Nintendo DS.

"Whenever I talk to him about football, he is not interested," Melvin says. "Like, period. He won't even watch it with me for more than three minutes."

Parker is now seven. He's playing chess. Taking karate lessons. Asking about soccer and basketball. He's a whip-smart student but also a handful, the kind of boy who finishes an assignment and then celebrates by doing cartwheels in the middle of the classroom. He says he wants to be an engineer when he grows up -- that is, after he learns how to cook at Le Cordon Bleu.

"He's into being a ninja turtle," Monet says.

Parker isn't playing football. Not this season. But if he asks to play again in the future, Monet and Melvin have made their choice. They'll definitely say no. Unless they say yes.

"Deep down, there's a side of me that would love him to go to the NFL and keep up the tradition," Monet says. "Do I want him on a football field? Absolutely. Do I know the repercussions? Absolutely. Do I think he should play? As a mom, absolutely not."

The phone rings. It's Mel Sr. We talk about football. About the choice. He thinks children should be allowed to participate. Thinks the sport builds character. Provides opportunity. He tells me a story: Back in Beaumont, his mother didn't want him and his brother, Miller, to play. But mom also worked. So the boys joined their school team in secret. Didn't tell their parents. They got away with it for about two weeks, until Miller came home with a busted lip.

"When I retired from football, I told my mom, 'My knees have given up,'" Mel Sr. says. "And she said to me, 'What do you think about my knees? I don't have to go on the floor anymore to pray.'"

Football is like the lottery. Thrilling to play. You probably won't win. But if you do, it can change your life. Forever. Only the prize isn't money.

Monet hugs her son.

"What do you want to do be when you grow up?" she says.

"An engineer," Parker says.

"Where do you want to go to school?"

"Georgia Tech."

Tank grins. He's missing two of his baby teeth. Monet smiles, too. She looks relieved. For now, at least, the choice has been made for her.